臨床泌尿器科69巻7号

2015年06月発行

特集 Onco-Nephrology—がん治療の最新フロンティア

Ⅱ．がん治療と腎障害

腎泌尿器系腫瘍に伴う腎障害

著者： 猪阪善隆¹

所属機関： ¹大阪大学大学院医学系研究科老年・腎臓内科学

ページ範囲：P.552 - P.557

文献概要

要旨　従来は小径腎細胞がんに対しても根治的腎摘除術が行われてきたが，最近，腎機能の温存を目的とした腎部分切除術が普及してきている。観察研究では，腫瘍径4cm以下（T1a）の腎がん患者において，腎部分切除術は制がん性の点でも根治的腎摘除術と同等であり，腎機能保持の面では優れていることが報告されている。ただし，唯一のRCTであるEORTC試験では，根治術のほうが生存率で良好な結果が得られており，今後のさらなる研究が必要である。一方，CKD発症と腎がん発症には共通したリスク因子が存在しており，手術時の潜在的な腎実質障害の程度が，術後の新規CKD発症に関連していることも示唆されている。

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